Our goal is to improve understanding of the benefits of screening and brief intervention (SBI) for unhealthy alcohol use for older medical patients. The study builds on the Massachusetts Screening, Brief Intervention and Referral to Treatment (MABIRT) project, funded by SAMHSA (Grant # TI 1U79TI018311). We plan to extend the MASBIRT analyses by conducting further client-level analyses using Medicare claims. The specific aims of this proposal are to: 1. Analyze changes in unhealthy alcohol use among older patients receiving a brief intervention through MASBIRT to demonstrate the influence of SBI on drinking behaviors of older adults. 2. Assess the level and types of co-morbid conditions among older patients screening positive for unhealthy alcohol use to increase understanding of the extent of co-morbid conditions and the relationship of SBI to changes in these conditions. 3. Determine whether SBIRT decreases healthcare utilization and costs among older patients in primary care, inpatient and emergency room settings to help physicians and healthcare system administrators better understand the relationship of SBI to healthcare use and whether SBI results in less acute care and lower healthcare costs. The study will link MASBIRT data (screening, alcohol use, past and family history) with Medicare claims. The sample will include all patients 65 and older who are screened by the MASBIRT project (N=505), with a comparison sample of Medicare patients 65 and older who were not screened by MASBIRT. Multivariate analyses will assess changes in drinking behavior, and healthcare use and costs, controlling for demographic characteristics, diagnoses indicating risk for alcohol problems, and co-morbid conditions. Relevance The study assesses the benefits of SBI for unhealthy alcohol use among older adults. Conclusions will inform federal, state and health policies and practices regarding the use of and payment for SBI among this growing population. The study will provide evidence of the relationship between unhealthy alcohol use and co-morbid conditions among older patients and whether SBI for older patients reduces unhealthy alcohol use, as well as healthcare utilization and costs. PUBLIC HEALTH RELEVANCE: This study will assess the benefits of screening and brief intervention (SBI) for unhealthy alcohol use among older adults and determine whether SBI in this population results in improved general health and lower healthcare costs. Conclusions will inform federal, state and health policies and practices regarding SBI among this growing population. The study will provide evidence of the relationship between unhealthy alcohol use and co-morbid conditions among older patients and whether SBI for older patients reduces unhealthy alcohol use, as well as healthcare utilization and costs.